- Fish oil
Fish oil is oil derived from the tissues of oily fish. Fish oils contain the omega-3 fatty acids eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), precursors of eicosanoids that are known to reduce inflammation throughout the body, and are thought to have many health benefits.[by whom?]
Fish do not actually produce omega-3 fatty acids, but instead accumulate them by consuming either microalgae or prey fish that have accumulated omega-3 fatty acids, together high quantity of antioxidants as iodide and selenium, from microalgae, where these antioxidants are able to protect the fragile polyunsaturated lipids from peroxidantion  . Fatty predatory fish like sharks, sword fish, tilefish, and albacore tuna may be high in omega-3 fatty acids, but due to their position at the top of the food chain, these species can also accumulate toxic substances (see biomagnification). For this reason, the U.S. Food and Drug Administration recommends limiting consumption of certain (predatory) fish species (e.g. albacore tuna, shark, king mackerel, tilefish and swordfish) due to high levels of toxic contaminants such as mercury, dioxin, PCBs and chlordane. Fish oil is used as a component in aquaculture feed. More than 50 percent of the world's fish oil used in aquaculture feed is fed to farmed salmon.
The omega-3 fatty acids in fish oil are thought to be beneficial in treating hypertriglyceridemia, and possibly beneficial in preventing heart disease. Fish oil and omega-3 fatty acids have been studied in a wide variety of other conditions, such as clinical depression, anxiety, cancer, and macular degeneration, although benefit in these conditions remains to be proven.
In 2005, fish oil production declined in all main producing countries with the exception of Iceland. The 2005 production estimate is about 570,000 tonnes in the five main exporting countries (Peru, Denmark, Chile, Iceland and Norway), a 12% decline from the 650,000 tonnes produced in 2004.. Peru continues to be the main fish oil producer worldwide, with about one fourth of total fish oil production.
Grams of omega-3 fatty acids per 3oz (85g) serving of popular fish. Common name grams Tuna 0.21–1.1 Tuna (canned, light) 0.17-0.24 Pollock 0.45 Salmon 1.1–1.9 Cod 0.15–0.24 Catfish 0.22–0.3 Flounder 0.48 Grouper 0.23 Halibut 0.60–1.12 Mahi mahi 0.13 Orange roughy 0.028 Red snapper 0.29 Shark 0.83 Swordfish 0.97 Tilefish 0.90 King mackerel 0.36
Several studies report possible anti-cancer effects of n−3 fatty acids found in fish oil (particularly breast, colon and prostate cancer). Omega-3 fatty acids reduced prostate cancer growth, slowed histopathological progression, and increased survival in genetically engineered mice. Among n-3 fatty acids (omega-3), neither long-chain nor short-chain forms were consistently associated with reduced breast cancer risk. High levels of docosahexaenoic acid, however, the most abundant n-3 polyunsaturated fatty acid (omega-3) in erythrocyte membranes, were associated with a reduced risk of breast cancer. In a recent study of 35,000 middle-aged women published in the journal Cancer Epidemiology, those that took fish oil supplements were found to have a 32% lower risk of breast cancer, although the study authors stressed that the result was preliminary and that "we should not draw any conclusions about a causal relationship."
The American Heart Association recommends the consumption of 1g of fish oil daily, preferably by eating fish, for patients with coronary heart disease although pregnant and nursing women are advised to avoiding eating fish with high potential for mercury contaminants including mackerel, shark, or swordfish. Note that optimal dosage relates to body weight.
The US National Institutes of Health lists three conditions for which fish oil and other omega-3 sources are most highly recommended: hypertriglyceridemia, secondary cardiovascular disease prevention and high blood pressure. It then lists 27 other conditions for which there is less evidence. It also lists possible safety concerns: "Intake of 3 grams per day or greater of omega-3 fatty acids may increase the risk of bleeding, although there is little evidence of significant bleeding risk at lower doses. Very large intakes of fish oil/omega-3 fatty acids may increase the risk of hemorrhagic (bleeding) stroke."
Studies published in 2004 and 2009 have suggested that the n-3 EPA may reduce the risk of depression and suicide. One such study took blood samples of 100 suicide-attempt patients and compared the blood samples to those of controls and found that levels of Eicosapentaenoic acid were significantly lower in the washed red blood cells of the suicide-attempt patients. A small American trial, published in 2009, suggests that E-EPA, as monotherapy, might treat major depressive disorder, however the study achieved no statistical significance.
Studies were conducted on prisoners in England where the inmates were fed seafood which contains omega-3 fatty acids. The higher consumption of these fatty acids corresponded with a drop in the assault rates. Another Finnish study found that prisoners who were convicted of violence had lower levels of omega–3 fatty acids than prisoners convicted of nonviolent offenses. It was suggested that these kinds of fatty acids are responsible for the neuronal growth of the frontal cortex of the brain which, it is further alleged, is the seat of personal behavior.
A study from the Orygen Research Centre in Melbourne suggests that omega-3 fatty acids could also help delay or prevent the onset of schizophrenia. The researchers enlisted 81 'high risk' young people aged 13 to 24 who had previously suffered brief hallucinations or delusions and gave half of them capsules of fish oil while the other half received fish-tasting dummy substitute. One year on, only three percent of those on fish oil had developed schizophrenia compared to 28 percent from those on the substitute. A study conducted at Sheffield University in England reported positive results with fish oil on patients suffering from schizophrenia. Dr. Malcolm Peet, Professor of Psychiatry at Sheffield University organized the study and followed the progress of the participants. Participants of the study were previously taking anti-psychotic prescription drugs but after some time were no longer effective on patients. After taking fish oil supplements, participants in the study experienced progress compared to others who were given a placebo.
According to a study from Louisiana State University in September 2005, Docosahexaenoic acid, an omega-3 fatty acid often found in fish oil, may help protect the brain from cognitive problems associated with Alzheimer's disease.
In the Northern Ireland study, lupus disease activity, especially in the skin and joints was significantly reduced in the patients who received the fish oil supplements, at both the 12-week and 24-week follow-up periods. No such reduction was seen in the lupus disease activity of the patients who got the placebo. There were also changes in the blood platelets of the patients who took the fish oil supplements, with an increase in proteins that are considered anti-inflammatory and a decrease in proteins that promote inflammation; these changes were not evident in the group that took placebo. The fish oil group showed an increase in FMD, which the researchers took as a sign that the omega-3 oils were helping the cells in the blood vessel walls to remain healthy.
A study examining whether omega-3 exerts neuroprotective action in Parkinson's disease found that it did, using an experimental model, exhibit a protective effect (much like it did for Alzheimer's disease). The scientists exposed mice to either a control or a high omega-3 diet from two to twelve months of age and then treated them with a neurotoxin commonly used as an experimental model for Parkinson's. The scientists found that high doses of omega-3 given to the experimental group completely prevented the neurotoxin-induced decrease of dopamine that ordinarily occurs. Since Parkinson's is a disease caused by disruption of the dopamine system, this protective effect exhibited could show promise for future research in the prevention of Parkinson's disease.
Evidence regarding the efficacy of fish oil supplements as a treatment for depression is currently inconclusive. Whereas several methodologically rigorous studies have reported statistically significant positive effects in the treatment of depressed patients, other studies have found effects to be small or insignificant.
For example, an August 2003 double-blind placebo-controlled study published in the journal European Neuropsychopharmacology found that among 28 patients with major depressive disorder, "patients in the omega-3 PUFA group had a significantly decreased score on the 21-item Hamilton Rating Scale for Depression than those in the placebo group." Another study in the American Journal of Psychiatry reported that the addition of fish oil supplements to regular maintenance anti-depression therapy conferred "highly significant" benefits by the third week of the trial.
In contrast, a 2005 randomized double-blind placebo-controlled study conducted under the auspices of the New Zealand Institute for Crop & Food Research found "no evidence that fish oil improved mood when compared to the placebo oil, despite an increase in circulating ω-3 polyunsaturated fatty acids." Similarly, another scholarly study published in October 2007 reported that fish oil supplements conferred no additional benefits beyond those conferred by standard treatment.
Diets supplemented with cod liver oil have also shown beneficial effects on psoriasis. Though it has not been proven, some claim that fish oil also improves the tone of the skin and the condition of the blood vessels. More studies would have to be done to understand whether this is true.
Omega-3 polyunsaturated fatty acids (commonly found in fish oil) protect against fetal brain injury and promotes fetal and infant brain health. Some studies reported better psycho motor development at 30 months of age in infants whose mothers received fish oil supplements for the first four months of lactation. In addition, five-year-old children whose mothers received modest algae based docosahexaenoic acid supplementation for the first 4 months of breastfeeding performed better on a test of sustained attention. This suggests that docosahexaenoic acid intake during early infancy confers long-term benefits on specific aspects of neurodevelopment.
Docosahexaenoic acid supplementation has also been found to be essential for early visual development of the baby. However, the standard western diet is severely deficient in these critical nutrients. This omega-3 dietary deficiency, a nutrient found in fish oil, is compounded by the fact that pregnant women become depleted in omega-3s, since the fetus uses omega-3s for its nervous system development. Omega-3s are also used after birth if they are provided in breast milk.
In addition, provision of fish oil during pregnancy may reduce an infant’s sensitization to common food allergens and reduce the prevalence and severity of certain skin diseases in the first year of life. This effect may persist until adolescence with a reduction in prevalence and/or severity of eczema, hay fever and asthma.
Omega-3 fatty acid supplementation is also beneficial to the mother. It has been shown to prevent pre-term labor and delivery. It is recommended that women who are breastfeeding consume fish oil at least twice a week, although the American Heart Association recommends pregnant and nursing women are to avoiding eating fish with high potential for mercury contaminants including mackerel, shark, or swordfish.
The liver and liver products (such as cod liver oil) of fish and many animals (such as seals and whales) contain omega-3, but also the active form of vitamin A. At high levels, this form of the vitamin can be dangerous (Hypervitaminosis A).
Fish oil supplements have sometimes come under scrutiny in recent years. In early 2006, government agencies such as the Food Standards Agency in the UK and the Food Safety Authority of Ireland reported PCB levels that exceeded the strict new European maximum limits in several fish oil brands, which required temporary withdrawal of these brands. To address the growing concern over contaminated fish oil supplements, the International Fish Oil Standards program, a voluntary review process, was created at University of Guelph.
Patented production purification processes do however exist in order to remove pollutants and dioxins from fish oil to levels far below the EU limits.
EU regulations have set a limit on the percentage of toxins that can be present in the oil for it to still be beneficial to the consumer. Recently, concerns in the UK and Ireland with regards to upholding the limits set have resulted in some major manufacturers taking their products off the market on a temporary basis.
A March 2010 lawsuit filed by a California environmental group claims that eight popular brands of fish oil supplements contained excessive levels of PCBs, including CVS/pharmacy, Nature Made, Rite Aid, GNC, Solgar, Twinlab, Now Health, Omega Protein and Pharmavite.
It should be noted, however, that the majority of these products were either cod liver or shark liver oils. Because the liver is the major filtering and detoxifying organ, PCB content will be much higher in such products than in the more common fish oil produced from the processing of whole fish.
An analysis based on data from the Norwegian Women and Cancer Study (NOWAC) with regards to the dangers of persistent organic pollutants (POPs) in cod liver came to the conclusion that "in Norwegian women, fish liver consumption was not associated with an increased cancer risk in breast, uterus, or colon. In contrast, a decreased risk for total cancer was found."
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- EPA Fish Consumption Advisories
- International Fish Oil Standards — An organization concerned with the quality of omega-3 products as it relates to the international standards established by the World Health Organization and the Council For Responsible Nutrition for purity and concentration.
- Joyce A. Nettleton, ed. "PUFA Newsletter". http://www.fatsoflife.com. Retrieved February 20, 2006. Two newsletters, both quarterly, reviewing recent publications in essential fatty acids. One is written for researchers, the second is for consumers. Industry sponsored, academic contributors.
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- Oil of Pisces — Summaries of the latest research concerning the health benefits of fish and fish oil
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